UN: H5N1 responses improving, but threat persists

Nov 30, 2007 (CIDRAP News) – Many countries have improved their responses to H5N1 avian influenza outbreaks in poultry in the past year, but the disease remains entrenched in six countries, according to a new report from the United Nations and the World Bank.

Amid the persisting threat that the H5N1 virus will spark a human flu pandemic, governments need to do more to coordinate their pandemic planning efforts, according to a UN news release about the report. The report itself was not released online.

"The pandemic threat has led most Governments to improve services to detect, contain and lessen the impact of dangerous pathogens," the UN statement says. "Many national pandemic plans, however, are not sufficiently operational and the coordination of pandemic planning between countries needs greater attention."

Dr. David Nabarro, the UN's senior influenza coordinator, commented in the statement, "The most urgent need, now, is for the Governments of different countries to work together. First, they must contain avian influenza and other animal diseases that might affect humans. Second, they must prepare for influenza and other possible pandemics."

The report was released in advance of a global conference on avian and pandemic flu, scheduled Dec 4 to 6 in New Delhi. The document comes a week after a World Health Organization (WHO) conference in Geneva made little headway toward solving a dispute over the international sharing of H5N1 virus samples and in the wake of poultry outbreaks in Romania, the United Kingdom, Saudi Arabia, Vietnam, Bangladesh, and Pakistan.

The report says H5N1 avian flu has been reported in 60 countries since 2003, according to a Nov 29 Reuters story. The UN statement does not list the six countries in which the virus remains well established, but the Reuters story quotes the report as saying the virus "is currently entrenched in Indonesia, Egypt and Nigeria, and possibly in some locations in China and Bangladesh."

Nabarro said H5N1 is being "continuously transmitted" in at least half the districts of Indonesia, according to an Agence France-Presse (AFP) report .

"Intensive control efforts—including vaccination of poultry—are being mounted in these settings [countries where the virus is entrenched] to get the disease under control and eliminate outbreaks when they occur," the UN said. "Under present conditions, most other countries are able to control outbreaks when they occur in other settings."

Reuters quoted the report as saying, "Outbreaks are being detected more rapidly and the response is more effective. However, animal health services are still substandard in most countries—they lack necessary regulatory frameworks, budgets, laboratory capacity and implementation of biosecurity measures."

In regard to governmental responses to poultry outbreaks, the report largely echoes a UN Food and Agriculture Organization (FAO) statement issued in June. At that point the FAO said responses to H5N1 outbreaks had improved significantly in the preceding 3 years but that the virus remained entrenched in several countries and would continue to spread.

The UN said nations that initially treated avian flu as an emergency are now developing "longer-term sustainable strategies for the healthy rearing and management of waterfowl, and investing in animal health, including better-run veterinary services."

The document also calls on countries to share H5N1 virus samples. Indonesia, the country hit hardest by avian flu, has shared very few samples over the past year, contending that the long-standing international system for flu surveillance is unfair because rich countries use virus samples from poor countries to develop vaccines that the poor countries can't afford.

A Nov 29 story from the UN News Service says the report calls for the urgent creation of a 3- to 5-year road map to drive intergovernmental action to control avian flu and improve global readiness for other health crises.

The UN report is based on data provided by 143 countries, the UN said. Ninety-five percent of the countries said they are planning for a pandemic. Some of these have taken steps to ensure continuity of vital infrastructure in a pandemic, and some have tested their plans in simulation exercises.